Characteristics of mental health recovery narratives: Systematic review and narrative synthesis.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2019
Historique:
received: 07 12 2018
accepted: 18 03 2019
entrez: 29 3 2019
pubmed: 29 3 2019
medline: 18 12 2019
Statut: epublish

Résumé

Narratives of recovery from mental health distress have played a central role in the establishment of the recovery paradigm within mental health policy and practice. As use of recovery narratives increases within services, it is critical to understand how they have been characterised, and what may be missing from their characterisation thus far. The aim of this review was to synthesise published typologies in order to develop a conceptual framework characterising mental health recovery narratives. A systematic review was conducted of published literature on the characteristics of mental health recovery narratives. Narrative synthesis involved identifying characteristics and organising them into dimensions and types; and subgroup analysis based on study quality, narrator involvement in analysis, diagnosis of psychosis and experience of trauma. The synthesis was informed by consultation with a Lived Experience Advisory Panel and an academic panel. The review protocol was pre-registered (Prospero CRD42018090188). 8951 titles, 366 abstracts and 121 full-text articles published January 2000-July 2018 were screened, of which 45 studies analysing 629 recovery narratives were included. A conceptual framework of mental health recovery narratives was developed, comprising nine dimensions (Genre; Positioning; Emotional Tone; Relationship with Recovery; Trajectory; Use of Turning Points; Narrative Sequence; Protagonists; and Use of Metaphors), each containing between two and six types. Subgroup analysis indicated all dimensions were present across most subgroups, with Turning Points particularly evident in trauma-related studies. Recovery narratives are diverse and multidimensional. They may be non-linear and reject coherence. To a greater extent than illness narratives, they incorporate social, political and rights aspects. Approaches to supporting development of recovery narratives should expand rather than reduce available choices. Research into the narratives of more diverse populations is needed. The review supports trauma-informed approaches, and highlights the need to understand and support post-traumatic growth for people experiencing mental health issues.

Sections du résumé

BACKGROUND
Narratives of recovery from mental health distress have played a central role in the establishment of the recovery paradigm within mental health policy and practice. As use of recovery narratives increases within services, it is critical to understand how they have been characterised, and what may be missing from their characterisation thus far. The aim of this review was to synthesise published typologies in order to develop a conceptual framework characterising mental health recovery narratives.
METHOD
A systematic review was conducted of published literature on the characteristics of mental health recovery narratives. Narrative synthesis involved identifying characteristics and organising them into dimensions and types; and subgroup analysis based on study quality, narrator involvement in analysis, diagnosis of psychosis and experience of trauma. The synthesis was informed by consultation with a Lived Experience Advisory Panel and an academic panel. The review protocol was pre-registered (Prospero CRD42018090188).
RESULTS
8951 titles, 366 abstracts and 121 full-text articles published January 2000-July 2018 were screened, of which 45 studies analysing 629 recovery narratives were included. A conceptual framework of mental health recovery narratives was developed, comprising nine dimensions (Genre; Positioning; Emotional Tone; Relationship with Recovery; Trajectory; Use of Turning Points; Narrative Sequence; Protagonists; and Use of Metaphors), each containing between two and six types. Subgroup analysis indicated all dimensions were present across most subgroups, with Turning Points particularly evident in trauma-related studies.
CONCLUSIONS
Recovery narratives are diverse and multidimensional. They may be non-linear and reject coherence. To a greater extent than illness narratives, they incorporate social, political and rights aspects. Approaches to supporting development of recovery narratives should expand rather than reduce available choices. Research into the narratives of more diverse populations is needed. The review supports trauma-informed approaches, and highlights the need to understand and support post-traumatic growth for people experiencing mental health issues.

Identifiants

pubmed: 30921432
doi: 10.1371/journal.pone.0214678
pii: PONE-D-18-35082
pmc: PMC6438542
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0214678

Subventions

Organisme : Department of Health
ID : RP-PG-0615-20016
Pays : United Kingdom

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Joy Llewellyn-Beardsley (J)

School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom.

Stefan Rennick-Egglestone (S)

School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom.

Felicity Callard (F)

Department of Psychosocial Studies, Birkbeck University, London, United Kingdom.

Paul Crawford (P)

School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom.

Marianne Farkas (M)

College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts, United States of America.

Ada Hui (A)

School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom.

David Manley (D)

Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, United Kingdom.

Rose McGranahan (R)

Unit of Social and Community Psychiatry, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.

Kristian Pollock (K)

School of Health Sciences, University of Nottingham, United Kingdom.

Amy Ramsay (A)

Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.

Knut Tore Sælør (KT)

Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, Center for Mental Health and Substance Abuse, University of South Eastern Norway, Kongsberg, Norway.

Nicola Wright (N)

School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom.

Mike Slade (M)

School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom.

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